The University of Oslo arranges digital public defences this semester, thus the disputation will be held as a video conference over Zoom.
The public defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.
Digital Trial Lecture – time and place
- First opponent: Clinical Professor Ismail Gögenur, University of Copenhagen
- Second opponent: Professor Arne Wibe, NTNU
- Third member and chair of the evaluation committee: Professor II Inger Nina Farstad, University of Oslo
Chair of the Defence
Professor Emeritus Tom Øresland, Unviersity of Oslo
Professor II Dejan Ignjatovic, University of Oslo
Surgery is the sole treatment that can cure colon cancer. Lymphatic spread is one of the ways the disease disseminates. Removal of lymphatic tissue draining the cancer is believed to improve the prognosis. Surgical method and technique are therefore of uttermost importance. The main aim of this dissertation is to report on aspects of introduction and implementation of right colectomy with extended D3 mesenterectomy anterior and posterior to the mesenteric vessels (RD3APM), a new surgical procedure for right sided colon cancer comprising extended lymphadenectomy. The specific aims of the thesis were to define minimal clearances for adequate lymphatic resection, to find out if three-dimensional reconstructed (3DR) vascular anatomy from CT scans provide reliable information about the relationships between the superior mesenteric blood vessels in the central mesentery, to classify the different vessel crossing patterns important to surgery, and to define, classify and demonstrate the trajectories, and also assess the clinical value of arterial and venous abnormalities. Furthermore, establish, prove feasibility, and provide short-term outcome data in 3DR CT guided open and laparoscopic anatomically correct RD3APM. Moreover, assess the impact of the open surgical procedure RD3APM on vessel stump lengths and the completeness of the lymphadenectomy.
Anatomical studies using cadavers, 3DR abdominal CT scans and photos taken during surgery were used to investigate the specific aims of these studies. In addition, immunohistochemically stained tissues from the dissected cadavers were examined.
Based on our findings, the volume of lymphatic tissue central in the mesentery draining the right colon was defined and this volume is resected with RD3APM. The 3DR were found to be a reliable roadmap for surgery and together with the findings and classification of normal and abnormal vascular anatomy central in the mesentery, were an aid to make this challenging surgery central in the mesentery safer and less demanding.
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